How can I tell if my back pin is oa or ra

[suzyrob]

Have both ra and oa, how can I tell if pain in back is oa and not morera

[dtech]

Go to a doctor?

[cathie]

I saw a knee surgeon about an op. He said that the difference between OA and RA was 'academic'. I think it meant that it didn't make a lot of difference for the op. not that it didn't really matter. I think there are some joints which are more commonly one than the other. I think you'd need someone to examine you and that might help.

[nomoreheels]

I have both cervical & lumbar spondylosis (OA), hips, knees & hands also & from my experience the only relief I've had from the pain is from 50mg amitriptyline nightly & BuTrans patch 20mcg/hr, both titrated over 4 months. The OA pain isn't responsive to my RD meds (MTX 15mg/17.5mg, steroids, Cox-2 NSAID etc) & my Rheumy has distinguished the two for me so yours should also be able to as well.

Generally early morning stiffness applies to both but my OA affected bits are also problematic if I sit for too long so I find exercising is important to help stop the creaking & the ooo aaah's. I've been doing more stretching ones recently as my pain has eased thanks to the meds & it's made quite a difference, especially tackling the stairs to go to bed. My knees no longer feel as though they'll give way or judder as much as I bend them going down stairs. I'm putting this down to the exercises strengthening the muscles that had started wasting as I wasn't inclined to exercise them when I was in pain.

So, either mention it at your next GP appointment (my Rheumy asked my GP to perform a pain med review for my OA) or if your next Rheumy visit is imminent even better. Whatever, the cause of your pain needs determining if it's anything like mine was!

[helixhelix]

I have both, and I find the type of pain is different. Also the OA I have in knees and back tends to ease up after I've got moving in the morning, but then gets worse throughout the day or if I sit for too long. The RA joints (hands, feet, wrists & elbows) take a long time to get going in the mornings, but then improve throughout the day. But both improve with gentle exercise.

But overall they both hurt so not sure I really care which is which!

[earthwitch]

....or it could be spondyloarthritis (another form of inflammatory arthritis), or osteoporosis or degenerative disc disease ...... I guess the only way to tell is to ask your doctor, and see what they say, and ask whether any tests would confirm it one way or the other.

[Hidden]

There's a lot to spinal arthritis so its best to do a lot of looking up and see a good doctor who can refer you in the right direction but I thought you may just want a quick unofficial viewpoint.

Im not a doctor so this is just things Ive learnt as I do suffer from both and have had many operations on my spine.

Xray and more importantly an MRI should show the difference but as Cathy said, its really academic to the cause, the treatment is the same for both depending on the health or damage of the nerve roots and spinal cord and vertebrae.

From what I have found out, you need tests to differentiate the two so the reports would probably say the endplates of the vertebrae in RA show erosive or sclerotic (rigid) changes to the vertebral bodies, whereas in OA they are "overgrown" with spurring and hypertrophy (thickening) to the bones and ligaments.

In RA there can be instability (sliding of one vertebra on top of another), narrowing and collapse of the vertebral/disc complex within these changes, but it also happens in OA so it would depend on the radiologists opinion as to the cause.

Its a lot more common to have OA rather than RA on the lower parts of the spine (thoracic and lumbar) but it does happen particularly where inflammation of the synovial joints (called 'facet joints' or 'apophyseal joints') stops production of the synovial fluid which help to lubricate the moving parts of the spine. These joints often also show cysts in rheumatoid patients.

Also a high percentage of people with RA show pannus (a localized mass/swelling of rheumatoid synovial tissue) on the cervical vertebra of C1/C2 which can eventually lead to instability requiring a fusion.

There isnt a lot of difference symptom-wise but here is a good link to show RA symptoms...

spine-health.com/conditions...

I think its best to first find out whether your pain is coming from the spine or not and remember conservative treatment (rest, medication, physio etc) is always tried for at least 2-3 mths (unless a neuro exam reveals more problems). It looks like about 95% respond to that so don't worry too much yet.

I hope the pain gets better soon.

[chalky1938]

Thats hard to say as I have both as well and I cant tell which is which

[Franm]

Hi

I suffer from horrendous back pain and have RA. One Doctor once told me once RA affects your joints - the bottom of your back being one of the biggest. Also when you have a flare up and walk - subconciously- differently to alleviate any pain, it puts more pressure on your back. So in answer to your question I dont think you'll get a definitive answer apart from its definately part of RA. I totally sympathise with you as its a different pain to the RA pain, difficult to explain unless you've experienced it, but I am sure you'll know what I mean. The only way I could control it to any degree was with morphine. Its become part of my illness now, but my heart goes out to you. I also find a lovely hotwater bottle helps. BIG gentle HUG.... Fran